IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v16y2019i9p1601-d228988.html
   My bibliography  Save this article

Determinants and Differences of Township Hospital Efficiency among Chinese Provinces

Author

Listed:
  • Bo Li

    (International College of Business and Technology, Tianjin University of Technology, Tianjin 300384, China
    School of Business and Economics, Thompson Rivers University, Kamloops, BC V2C 0C8, Canada)

  • Muhammad Mohiuddin

    (School of Business and Economics, Thompson Rivers University, Kamloops, BC V2C 0C8, Canada)

  • Qian Liu

    (School of Public Health, Tianjin Medical University, Tianjin 300070, China)

Abstract

This study aimed to measure the efficiency and change in efficiency over time of township hospitals among Chinese provinces, to decompose the difference in efficiency between districts, and to study the correlations between the difference in efficiency and its determinants. Based on Chinese provincial panel data, the empirical analysis was established using data envelopment analysis (DEA), Malmquist index, Theil index decomposition method and Grey correlation analysis method. First, it was found that the township hospitals in most provinces were operating in an inefficient state, and the township hospitals in most provinces achieved gains in efficiency. Second, from 2003 to 2016 the shrinkage of the difference in provincial efficiency of township hospitals progressed slowly. Intra-regional difference is the main cause of the overall provincial efficiency difference of Chinese township hospitals, while inter-regional difference is the minor cause of the overall difference. Third, the correlation between the difference of overall provincial efficiency and the difference of economic development level is the highest among all the correlations, while other determinants rank second to seventh place in their degree of correlation with respect to the overall difference in provincial efficiency. Furthermore, the correlations between the intra-regional difference of provincial efficiency of Chinese township hospitals and its determinants vary tremendously across regions. Based on our findings, we can conclude, first, that efforts should be made to improve the overall provincial difference in efficiency of Chinese township hospitals, and enhance the utilization level of input resources, and to reduce resource waste. Second, in order to shrink the overall provincial efficiency of Chinese township hospitals, the most important measure that should be taken is to improve the economic development level in relatively backward provinces in order to lay a solid economic foundation for the improvement of efficiency and shrink the differences in efficiency between provinces. Third, more attention should be paid to the shrinkage of intra-regional efficiency differences in Chinese township hospitals, while the narrowing of inter-regional efficiency difference should not be ignored. For each region, it is necessary to recognize the difference in the relative importance of determinants, and to make development strategies according to local conditions so as to make full use of local characteristics and advantages.

Suggested Citation

  • Bo Li & Muhammad Mohiuddin & Qian Liu, 2019. "Determinants and Differences of Township Hospital Efficiency among Chinese Provinces," IJERPH, MDPI, vol. 16(9), pages 1-16, May.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:9:p:1601-:d:228988
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/16/9/1601/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/16/9/1601/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Ng, Ying Chu, 2011. "The productive efficiency of Chinese hospitals," China Economic Review, Elsevier, vol. 22(3), pages 428-439, September.
    2. Yang, Lianping & Liu, Chaojie & Ferrier, J. Adamm & Zhang, Xinping, 2015. "Organizational barriers associated with the implementation of national essential medicines policy: A cross-sectional study of township hospitals in China," Social Science & Medicine, Elsevier, vol. 145(C), pages 201-208.
    3. Kai Xing & Xue Zhang & Mingli Jiao & Yu Cui & Yan Lu & Jinghua Liu & Jingjing Zhang & Yuchong Zhao & Yanming Zhao & Ye Li & Libo Liang & Zheng Kang & Qunhong Wu & Mei Yin, 2016. "Concern about Workplace Violence and Its Risk Factors in Chinese Township Hospitals: A Cross-Sectional Study," IJERPH, MDPI, vol. 13(8), pages 1-11, August.
    4. Charnes, A. & Cooper, W. W. & Rhodes, E., 1978. "Measuring the efficiency of decision making units," European Journal of Operational Research, Elsevier, vol. 2(6), pages 429-444, November.
    5. Ham, Chris, 2010. "The ten characteristics of the high-performing chronic care system," Health Economics, Policy and Law, Cambridge University Press, vol. 5(1), pages 71-90, January.
    6. Li, Sung Ko & He, Xinju, 2019. "The impacts of marketization and subsidies on the treatment quality performance of the Chinese hospitals sector," China Economic Review, Elsevier, vol. 54(C), pages 41-50.
    7. Audibert, Martine & Mathonnat, Jacky & Pelissier, Aurore & Huang, Xiao Xian & Ma, Anning, 2013. "Health insurance reform and efficiency of township hospitals in rural China: An analysis from survey data," China Economic Review, Elsevier, vol. 27(C), pages 326-338.
    8. Afonso, António & Fernandes, Sónia, 2008. "Assessing and explaining the relative efficiency of local government," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 37(5), pages 1946-1979, October.
    9. Emrouznejad, Ali & Parker, Barnett R. & Tavares, Gabriel, 2008. "Evaluation of research in efficiency and productivity: A survey and analysis of the first 30 years of scholarly literature in DEA," Socio-Economic Planning Sciences, Elsevier, vol. 42(3), pages 151-157, September.
    10. Filipe Amado, Carla Alexandra & Dyson, Robert G., 2008. "On comparing the performance of primary care providers," European Journal of Operational Research, Elsevier, vol. 185(3), pages 915-932, March.
    11. Zhifei He & Zhaohui Cheng & Hang Fu & Shangfeng Tang & Qian Fu & Haiqing Fang & Yue Xian & Hui Ming & Zhanchun Feng, 2015. "Factors Associated with the Competencies of Public Health Workers in Township Hospitals: A Cross-Sectional Survey in Chongqing Municipality, China," IJERPH, MDPI, vol. 12(11), pages 1-16, November.
    12. Cordero, José Manuel & Alonso-Morán, Edurne & Nuño-Solinis, Roberto & Orueta, Juan F. & Arce, Regina Sauto, 2015. "Efficiency assessment of primary care providers: A conditional nonparametric approach," European Journal of Operational Research, Elsevier, vol. 240(1), pages 235-244.
    13. Gerdtham, Ulf-G. & Sogaard, Jes & Andersson, Fredrik & Jonsson, Bengt, 1992. "An econometric analysis of health care expenditure: A cross-section study of the OECD countries," Journal of Health Economics, Elsevier, vol. 11(1), pages 63-84, May.
    14. Martine Audibert & Jacky Mathonnat & Aurore Pelissier & Xiao Xian Huang & Anning Ma, 2013. "Health insurance reform and efficiency of township hospitals in rural China: An analysis from survey data," Post-Print halshs-01230210, HAL.
    15. Yang, Jinqiu & Zeng, Wu, 2014. "The trade-offs between efficiency and quality in the hospital production: Some evidence from Shenzhen, China," China Economic Review, Elsevier, vol. 31(C), pages 166-184.
    16. Adam Wagstaff & Magnus Lindelow & Shiyong Wang & Shuo Zhang, 2009. "Reforming China's Rural Health System," World Bank Publications - Books, The World Bank Group, number 2646, December.
    17. Wei, Xiaolin & Li, Renzhong & Zou, Guanyang & Walley, John & Newell, James & Liu, Zhimin, 2010. "Evaluating the policy of setting up microscopy centres at township hospitals in Shandong China: Experience from patients and providers," Health Policy, Elsevier, vol. 95(2-3), pages 113-121, May.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Shaohong Mu & Weixiu Li & Muhammad Mohiuddin, 2022. "The Impact of Low-Carbon City (LCC) on Elderly People’s Health: Evidence from a Natural Experiment in China," IJERPH, MDPI, vol. 19(15), pages 1-18, August.
    2. Wanchun Xu & Zijing Pan & Shan Lu & Liang Zhang, 2020. "Regional Heterogeneity of Application and Effect of Telemedicine in the Primary Care Centres in Rural China," IJERPH, MDPI, vol. 17(12), pages 1-15, June.
    3. Domenica Matranga & Filippa Bono & Laura Maniscalco, 2021. "Statistical Advances in Epidemiology and Public Health," IJERPH, MDPI, vol. 18(7), pages 1-5, March.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Akkan, Can & Karadayi, Melis Almula & Ekinci, Yeliz & Ülengin, Füsun & Uray, Nimet & Karaosmanoğlu, Elif, 2020. "Efficiency analysis of emergency departments in metropolitan areas," Socio-Economic Planning Sciences, Elsevier, vol. 69(C).
    2. See, Kok Fong & Ng, Ying Chu, 2021. "Do hospital reform and ownership matter to Shenzhen hospitals in China? A productivity analysis," Economic Analysis and Policy, Elsevier, vol. 72(C), pages 145-155.
    3. Laurène PETITFOUR & Xiezhe HUANGFU & Martine AUDIBERT & Jacky MATHONNAT, 2017. "Efficiency of township hospitals in China in the context of the drug policy reform: Progress should not get bogged in midstream - A case study from a survey in Weifang prefecture," Working Papers P185, FERDI.
    4. Xueli Chen & Vivian Valdmanis & Tuotuo Yu, 2020. "Productivity Growth in Chinese Medical Institutions during 2009–2018," Sustainability, MDPI, vol. 12(8), pages 1-17, April.
    5. Sebastian Kohl & Jan Schoenfelder & Andreas Fügener & Jens O. Brunner, 2019. "The use of Data Envelopment Analysis (DEA) in healthcare with a focus on hospitals," Health Care Management Science, Springer, vol. 22(2), pages 245-286, June.
    6. Laurène PETITFOUR & Xiezhe HUANGFU & Martine AUDIBERT & Jacky MATHONNAT, 2017. "Efficiency of township hospitals in China in the context of the drug policy reform: Progress should not get bogged in midstream - A case study from a survey in Weifang prefecture," Working Papers P185, FERDI.
    7. Cordero Ferrera, Jose Manuel & Alonso Morán, Edurne & Nuño Solís, Roberto & Orueta, Juan F. & Souto Arce, Regina, 2013. "Efficiency assessment of primary care providers: A conditional nonparametric approach," MPRA Paper 51926, University Library of Munich, Germany.
    8. Zhang, Cai Wen & Yang, Yuanhui, 2023. "Appraisal of regional hospital efficiency and healthcare quality in China: Impacts of subsidies and marketization," Socio-Economic Planning Sciences, Elsevier, vol. 89(C).
    9. Giménez, Víctor & Prieto, William & Prior, Diego & Tortosa-Ausina, Emili, 2019. "Evaluation of efficiency in Colombian hospitals: An analysis for the post-reform period," Socio-Economic Planning Sciences, Elsevier, vol. 65(C), pages 20-35.
    10. Cordero, José Manuel & Alonso-Morán, Edurne & Nuño-Solinis, Roberto & Orueta, Juan F. & Arce, Regina Sauto, 2015. "Efficiency assessment of primary care providers: A conditional nonparametric approach," European Journal of Operational Research, Elsevier, vol. 240(1), pages 235-244.
    11. Jing You, 2016. "Lending to Parents and Insuring Children: Is There a Role for Microcredit in Complementing Health Insurance in Rural China?," Health Economics, John Wiley & Sons, Ltd., vol. 25(5), pages 543-558, May.
    12. Maria Teresa Balaguer‐Coll & Isabel Narbón‐Perpiñá & Jesús Peiró‐Palomino & Emili Tortosa‐Ausina, 2022. "Quality of government and economic growth at the municipal level: Evidence from Spain," Journal of Regional Science, Wiley Blackwell, vol. 62(1), pages 96-124, January.
    13. Audibert, Martine & Mathonnat, Jacky & Pelissier, Aurore & Huang, Xiao Xian & Ma, Anning, 2013. "Health insurance reform and efficiency of township hospitals in rural China: An analysis from survey data," China Economic Review, Elsevier, vol. 27(C), pages 326-338.
    14. Zhiyang Shen & Vivian Valdmanis, 2020. "Identifying the contribution to hospital performance among Chinese regions by an aggregate directional distance function," Health Care Management Science, Springer, vol. 23(1), pages 142-152, March.
    15. Nikolaos Oikonomou & Yannis Tountas & Argiris Mariolis & Kyriakos Souliotis & Kostas Athanasakis & John Kyriopoulos, 2016. "Measuring the efficiency of the Greek rural primary health care using a restricted DEA model; the case of southern and western Greece," Health Care Management Science, Springer, vol. 19(4), pages 313-325, December.
    16. Martine AUDIBERT & Marlène GUILLON & Jacky MATHONNAT, 2018. "The challenge of improving efficiency of Soum Health Centers in Mongolia," Working Papers P226, FERDI.
    17. Martine AUDIBERT & Marlène GUILLON & Jacky MATHONNAT, 2018. "The challenge of improving efficiency of Soum Health Centers in Mongolia," Working Papers P226, FERDI.
    18. Laurene Petitfour & Xiezhe Huangfu & Martine Audibert & Jacky Mathonnat, 2015. "Estimating and explaining the efficiency of township hospitals in Shandong province in the context of the drug policy reform," Working Papers halshs-01180621, HAL.
    19. Rita Bastião & Nuno de Sousa Pereira, 2020. "Performance in the Delivery of Primary Health Care Services: A Longitudinal Analysis," CEF.UP Working Papers 2002, Universidade do Porto, Faculdade de Economia do Porto.
    20. Kalinichenko, Olena & Amado, Carla A.F. & Santos, Sérgio P., 2022. "Exploring the potential of Data Envelopment Analysis for enhancing pay-for-performance programme design in primary health care," European Journal of Operational Research, Elsevier, vol. 298(3), pages 1084-1100.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:16:y:2019:i:9:p:1601-:d:228988. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.